Liver and Biliary Tract

  • Spiros P. Hiotis
  • Hersch L. Pachter


You are asked to see a 32-year-old intensive care unit patient in the medical service who is febrile and lethargic with a history, according to her husband—a selfproclaimed recluse—of shaking chills and who needs evaluation and possible management. With the exception of hospitalization for childbirth (youngest child is 1 year old), the patient has no known medical problems. On physical examination, the patient is jaundice and has right upper quadrant tenderness. There is no rebound tenderness. The patient was recently started on pressors to achieve hemodynamic stability. Pertinent positive laboratory results include an alkaline phosphatase level of 600, a total bilirubin level of 6 (direct −4.5), and a white blood cell count of 15,000. The patient has been receiving full-spectrum antibiotics for 36 hours. Which of the following recommendations should your acute care surgical consultation render?


Acute Pancreatitis Common Bile Duct Acute Cholecystitis Transjugular Intrahepatic Portosystemic Shunt Liver Abscess 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • Spiros P. Hiotis
    • 1
  • Hersch L. Pachter
    • 1
  1. 1.Department of SurgeryNew York University School of MedicineNew YorkUSA

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